- The coronary calcium scan is an
increasingly popular procedure
for the early detection of coronary atherosclerosis.
And the purpose of the test is to detect
and treat coronary artery disease
and vascular disease before it causes
a clinical problem, like a stroke or a heart attack.
We know that there are people walking around
with heart disease, but like an iceberg,
a lot of what happens with heart disease,
happens below the surface, and if you don't look for it,
you won't find it.
The traditional testing that we've done,
like stress testing, has a lot of deficiencies.
For example, a 50% blocked artery
would not show up on a treadmill test or a stress test.
But you would see it on a coronary calcium score test.
And even though that plaque is not causing problems now,
it may cause a serious problem in the near future.
So, the aggressive treatment of patients
with asymptomatic atherosclerotic heart disease
and vascular disease is really the goal
of the coronary calcium score.
By scoring the patient's calcium,
you can estimate the amount of plaque
they have in their arteries,
even before it's causing any symptoms.
It's been validated that the higher your calcium score,
the higher your risk for a future heart attack or stroke.
We think the value of that test
is that it makes patients aware
that they have heart disease before any damage can be done,
so they can become much more vigilant
about risk factors
such as smoking, blood pressure, and cholesterol.
I'm a big believer in the aggressive treatment
of asymptomatic coronary disease,
including the use of cholesterol-lowering medications,
blood thinners, and supplements
prior to them having a problem.
Coronary calcium scoring is probably best applied
to people in the middle somewhere.
So, if you've already had bypass surgery or a stent,
a coronary calcium score is not gonna do you very much good.
On the other end of the spectrum,
if you're a 19 year old woman or a 25 year old man,
with no other risk factors,
the coronary calcium score is very likely
to not be very helpful.
However, if you have at least one or two
coronary risk factors, and you're over the age of 35,
then the test can be worth while
in delineating what your risk is.
Not only because you get a score,
but you also get the score compared to other people
your age and gender so you can decide
whether or not you have more plaque in your arteries
than somebody else in your age group.
And that can be a real wake up call for some people.
On the other hand, if your calcium score comes back zero,
that's also very reassuring for those people
who are worried about the status of their heart,
or maybe some symptoms that they're having.